Limited thymectomy for stage I or II thymomas

Onuki, Takuya; Ishikawa, Shigemi; Iguchi, Kesato; Goto, Yukinobu; Sakai, Mitsuaki; Inagaki, Masaru; Yamamoto, Tatsuo; Onizuka, Masataka; Satô, Yukio; Ohara, Kiyoshi; Sakakibara, Yuzuru

doi:10.1016/j.lungcan.2009.08.001

Cited by 45 publications

(53 citation statements)

References 25 publications

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“…Ito et al (18) reported that the incidence of postoperative MG was 5.0% in the thymectomy group and 4.2% in the thymomectomy group, with no significant difference between the two groups. Similar results were reported by Tseng et al (3) and Onuki et al (2). In the present study, only two patients (0.81%) without preoperative MG developed MG after surgery, both in the thymectomy group.…”

Section: Discussionsupporting

confidence: 93%

“…However, there is no consensus on the appropriate extent of thymic resection (2)(3)(4). Although thymectomy may help prevent potential risks of postoperative myasthenia gravis (MG) and intrathymic or locoregional recurrence (5,6), some consider that tumor resection alone (thymomectomy) may be enough for noninvasive thymomas without MG (2,3).…”

Section: Introductionmentioning

confidence: 99%

“…And advent of minimally invasive surgery in recent years also contributed to increased interest in video-assisted thoracoscopic surgery (VATS) thymomectomy (7). Although some single-center studies have shown no statistical differences in diseasefree survival between thymectomy and thymomectomy, the follow-up durations were relatively short despite of the rarity and the indolent nature of thymomas (2,3). Thus, it is important to compare long-term outcomes on a larger patient population base so as to determine the appropriate extent of resection for the disease.…”

Section: Introductionmentioning

confidence: 99%

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Thymectomy versus tumor resection for early-stage thymic malignancies: a Chinese Alliance for Research in Thymomas retrospective database analysis

Shen

et al. 2016

J. Thorac. Dis.

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Background: To evaluate the surgical outcomes of tumor resection with or without total thymectomy for thymic epithelial tumors (TETs) using the Chinese Alliance for Research in Thymomas (ChART) retrospective database. Methods: Patients without preoperative therapy, who underwent surgery for early-stage (Masaoka-Koga stage I and II) tumors, were enrolled for the study. They were divided into thymectomy and thymomectomy groups according to the resection extent of the thymus. Demographic and surgical outcomes were compared between the two patients groups.Results: A total of 1,047 patients were enrolled, with 796 cases in the thymectomy group and 251 cases in the thymomectomy group. Improvement rate of myasthenia gravis (MG) was higher after thymectomy than after thymomectomy (91.6% vs. 50.0%, P<0.001). Ten-year overall survival was similar between the two groups (90.9% after thymectomy and 89.4% after thymomectomy, P=0.732). Overall, recurrence rate was 3.1% after thymectomy and 5.4% after thymomectomy, with no significant difference between the two groups (P=0.149). Stratified analysis revealed no significant difference in recurrence rates in MasaokaKoga stage I tumors (3.2% vs. 1.4%, P=0.259). However in patients with Masaoka-Koga stage II tumors, recurrence was significantly less after thymectomy group than after thymomectomy (2.9% vs. 14.5%, P=0.001).

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Thymectomy versus tumor resection for early-stage thymic malignancies: a Chinese Alliance for Research in Thymomas retrospective database analysis

Shen

et al. 2016

J. Thorac. Dis.

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“…As the prognosis of the patients with early-staged thymoma has been extremely good, limited thymectomy may be utilized. Onuki et al reported the efficacy of limited thymectomy for stage I or II thymomas (15). If the tumor invasion to the surrounding organs is apparent intraoperatively, we should convert the operative procedures from limited thymectomy to extended or total thymectomy.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological analysis of small-sized thymoma with podoplanin and Ki 67 expression analysis

Yokota

Tateyama

Yano

et al. 2012

Molecular and Clinical Oncology

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Abstract. Thymoma is the most common tumor of the anterior mediastinum for which surgical resection is currently the primary form of treatment. An increase in the incidence of a small-sized (≤3 cm) thymoma (SST) has recently been noted. Clinicopathological factors and prognosis of SST have not been reported previously. In this study, the clinicopathological data of 21 SST patients were reviewed and podoplanin and Ki67 immunohistochemistry were assessed to determine the biological behavior of SSTs. Pathological diagnosis of SSTs revealed the following types: A (n=1), AB (n=8), B1 (n=5), B2 (n=6) and B3 (n=1). The Masaoka-Koga stages of 21 thymoma patients were I (n=16), II (n=3), III (n=1) and IVb (n=1). In the case of the stage IVb thymoma, phrenic nerve, mediastinal pleura invasion and anterior mediastinal lymph node metastasis were observed. The Ki67 labeling index of this stage IVb was found to be 3.2. This case was also positive for podoplanin and was one of the only 2 cases that were positive for podoplanin. This patient succumbed to thymoma. Advanced stage thymomas are possibly included in SSTs although the majority of SSTs are classified into early stages of disease. Findings of this study suggest that podoplanin analyzed by immunohistochemistry may be useful to determine the malignant behavior of SSTs.

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“…We read with interest the paper entitled "Limited thymectomy for stage I and II thymomas" [1]. The ideal treatment for patients with thymoma is still debated; however, most of the discussion is dedicated to advanced stage lesions [2].…”

Section: Surgical Treatment Of Early Stage Thymomamentioning

confidence: 99%

Surgical treatment of early stage thymoma

et al. 2010

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Limited thymectomy for stage I or II thymomas

Abstract: Resection of thymomas with surrounding tissue instead of total thymectomy can be indicated for stage I or II thymomas in light of disease free and overall survival, post-operative onset of MG, and the incidence of multiple lesions.

Cited by 45 publications

References 25 publications

Thymectomy versus tumor resection for early-stage thymic malignancies: a Chinese Alliance for Research in Thymomas retrospective database analysis

Thymectomy versus tumor resection for early-stage thymic malignancies: a Chinese Alliance for Research in Thymomas retrospective database analysis

Clinicopathological analysis of small-sized thymoma with podoplanin and Ki 67 expression analysis

Surgical treatment of early stage thymoma

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